resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
The Recliner Test
"Hi, Bill, how are you?" "Oh, I'm OK, Doc. I've got pain down the leg again, so I thought I would stop by and get you to check it."
News in Brief
In Remembrance: A Moment of Silence for Dr. Dick Versendaal; NYCC Named Chiropractic College of the Year by ACA; National University Partners With Indiana VA Facility.
Enhancing TCM with Enzymes
Herbal formulations are an integral component for most Traditional Chinese Medicine (TCM) practitioners. One of the best ways to enhance their effectiveness is the addition of plant-based enzymes.
Are You Driving Patients Toward Dependence on Big Pharma?
Over the years I have had the opportunity to talk to doctors of chiropractic about health promotion, wellness and preventive care in chiropractic practice.
Alternatives to the Rainy Day Fund: Better Things to Do With Your Money
Google "rainy day fund" and you'll find the predominant and traditional advice given today is that you need to have three months of living expenses saved for an emergency. Some even recommend six months or more.
Chinese Herbs Debut at the Cleveland Clinic
Chinese herbal medicine is now being prescribed at the Cleveland Clinic thanks to a trailblazing team of people.
Making Sense of Chronic Inflammation
Inflammation is big business, evidenced by not only the laundry lists of medications patients bring me aimed at managing inflammation, but also the never-ending stream of advertisements for anti-inflammatory supplements that constantly find their way to my desk.
Revisiting the Neurological Exam
In spinal trauma or disease, the neurological exam chiefly aims to determine whether one (or more) of three basic neurological conditions is present: myelopathy, radiculopathy and peripheral nerve disorder.
Dry Needling is Acupuncture: Anatomy of a Legal Victory in Oregon
On January 23, 2014, the Oregon Court of Appeals overturned the Oregon Board of Chiropractic Examiners "dry needling" administrative rule, which allowed chiropractic physicians to perform acupuncture after only 24 hours of training.
Environmental Toxins: Cause of Modern Illness (Part I)
Environmental toxins have created burdens on the human body that put demands beyond our evolutionary development. Modern diseases that historically did not exist to any great degree have been rising sharply in the last 40 years.
Dietary Supplement Research: Contradictions, Bias, Misinterpretation and Confusion
I do not care what the truth is, one way or another; I just want to know it. And when it comes to dietary supplements, the truth can be hard to find for a number of reasons.
We Get Letters & E-Mail
Shouldn't the Pentagon Know More About Chiropractic Care? Office Flow: Have You Reviewed the Patient Experience Lately? Let's Stop Confusing the Public About Chiropractic; Cutting Down the Cherry Tree.
Colorado to Have the First Acupuncture Medical Reserve Corps in the U.S.
In the summer of 2012, Colorado was on fire. Literally. Many acupuncturists from around the state, especially those who had received disaster response training through AWB, wanted to help those affected by the fires as well as the first responders and tireless state and local officials, with the healing and stress-relief of acupuncture.
Evaluating Prenatal and Pediatric Automobile Injuries
Often in a family practice, one of your patients or an entire family is in an automobile accident and you are sought out to provide care for their soft-tissue injuries.
AAAOM: Facing An Ultimatum
On the heels of the growing discontent with leaders of the AAAOM, the Council of State Associations (CSA) recently took it upon themselves to present the organization with an ultimatum: for all board members to resign from the board and turn the organization over to the CSA or they will proceed on their own to become the primary representative of the AOM profession.
How Much is Enough?
One of the primary arguments used against acupuncture care is the overuse of treatment. Some people say, "once you go, you have to go forever."
Arch Height and Running Shoes: The Best Advice to Give Patients
Because runners with different arch heights are prone to different injuries, running shoe manufacturers have developed motion-control, stability and cushion running shoes for low-, neutral- and high-arched runners, respectively.
Chiropractic Management of Sports-Related Tendinopathy
Tendinopathy is increasing in prevalence and accounts for a substantial percentage of sports injuries. Despite the magnitude of the disorder, research on chiropractic treatment is limited.
Through the Eyes of a Child
Once upon a time there was a girl name Lucy. Lucy had cancer, but she had a heart filled with love and compassion. Please come along to hear this story of an amazing child, her tenacity and her dream to help other children.
Anti-Aging: Educating Your Patients About The Skin
We know that cosmetic acupuncture works but what then? Education is a key part to the practice of Chinese medicine and when you practice cosmetic acupuncture, facial rejuvenation, etc., it is time talk about skin with your patients.
Your Chance to Go Back to High School
As the father of a student who recently entered high-school sports (soccer), I have come to recognize an untapped opportunity for the chiropractic profession.
San Zhen Protocols Part II: Case Studies
In my last article, I presented a collection of three-point acupuncture combinations which can provide effective clinical results.
Socializing In My Slippers
When I graduated college, I had grandiose dreams of becoming an amazing acupuncturist. I wanted to build a great practice and make a good living. For four years, 13 semesters to be exact, I had a spreadsheet.
The Right Idea at the Right Time
On Feb. 28, 2014, Virginia Governor Terry McAuliffe appointed David Brown, DC, as new director of the Virginia Department of Health Professions.
Shoulder Strategies: Reduce Pain, Improve Function With Proper Taping
Shoulder pain / dysfunction is a common problem for chiropractic patients. Clinicians who utilize elastic therapeutic taping as part of their treatment approach know it can be effective for a variety of shoulder problems.
March, 2005, Vol. 05, Issue 03
The Inside-Out Paradigm: Equalizing the Pressure
By Dale G. Alexander, LMT, MA, PhD
Read Dale's previous article, "Healing From the Core: A New Paradigm," Parts 1 & 2, in the Sept. and Oct. 2004 issues of Massage Today at: www.massagetoday.com/archives/2004/09/20.html and www.massagetoday.com/archives/2004/10/04.html.
This article will explore a few of the many elements of anatomy and physiology that are fundamental to the proposed paradigm of working from the "inside-out." My first article, "Healing From the Core: A New Paradigm," postulated three core elements that assist the healing process:
The centerpiece of this paradigm is simply to work with how the body maintains itself physiologically and proprioceptively at the same time. Most biomechanical models infer that the source of constricted vascular circulation is the result of the extrinsic musculature's battle to maintain body posture within and against the field of gravity. This is partially accurate. However, it is postulated that contraction of the visceral suspension is a more primary source of vascular congestion and that much of what throws the proprioceptive balance off in the first place is the result of how the body discharges visceral tension into the intrinsic musculature, which then affects the kinetic chain of the joints, thus placing a demand on the extrinsic musculature to contract in order to protect individual joints and the overall balance of an individual. It is a complex both/and scenario. But with further exploration, it will become clearer.
An overlooked aspect of anatomy in our work as massage therapists is that the human body has three great cavities designed to assist the movement of fluids and support the upright carriage of our human structure based on the pressure differences between them. These are the abdominal-pelvic; the thorax; and the cranium.
According to Dr. Jean-Pierre Barral, the developer of Visceral Manipulation, the pressure of the thoracic cavity in a healthy system is negative in relation to the more positive pressures within abdominal-pelvic and cranial cavities. This negative pressure also acts like a helium balloon to support our posture in the field of gravity.1
This difference in the pressure relationships between the cavities is how the efficiency of the low pressure venous and lymphatic systems is normally maintained in their job of returning their fluids back to the heart and lungs to be re-nourished and recycled. Let us remember that fluid moves from an area of greater concentration to an area of lesser concentration naturally. Thus, as one assists the body to re-establish the negative pressure within the thoracic cavity, it allows for an equalization of pressures between the cavities.
How does one tell if the thoracic pressure has become more positive with a client on your massage table? Simple palpation and soft compression of the thorax will readily indicate to you the degree of positive pressure. The less flexible the thorax, the more positive the pressure and, by inference, the slower the flow of venous and lymph return.
Within the body's three great cavities are four visceral sacs:
Each of these sacs is related to physiological waves of expansion and contraction, which are crucial to normal fluid circulation. Their rhythms support the healing process and maintain normal homeostatic regulation:
All of these rhythms are influenced by the pressure within the cavities and sacs, and by the pressure of the tubes within the sacs and by the pressure within those tubes, which pass between the sacs and cavities. Obviously, this adds emphasis to the tone and length of the esophagus, as it is the connecting tube between the cranial vault, thoracic cavity, and abdominal/pelvic cavity. It offers a release valve to the pressures, which often build up within the alimentary canal in addition to the anus at the lower end.
These rhythms are homeostatically regulated between the two divisions of the Autonomic Nervous System; the parasympathetic outflow of the vagus and pelvic splanchnic nerves and the sympathetic nerves exiting from T1-L2 of the spinal cord. It is the flexibility between these two divisions, which regulates who gets the blood thereby the oxygen and nutrients needed to support the healing process.2
How does this pressure in the tubes, sacs and cavities build in the first place? By soft-tissue contraction of the sacs and tubes of the viscera, which lessens the space for the liquids and gases within them. This internal contraction pressurizes the contents. When this pressure is unable to equalize, it builds. The building of pressure creates more soft-tissue tension. The cycle repeats again and again. The body attempts to distribute these tensions both directly and reflexively.
The theorized direct method was described in the first article: visceral tensions build, then spill over into the intrinsic musculature, which then pull on the osseous system until a dysfunction of motion is created affecting joint range of motion. This both releases some of the internal pressure, but also stimulates the extrinsic musculature to contract to protect the joints from further displacement. Inevitably, one's posture and sense of balance is also affected.
The reflexive method involves the distribution of tensions and strain through more generalized viscero-somatic reflex arcs. These relate to both segmental levels of the spinal cord and regional areas that have come to be recognized by surgeons as indicators of acute organ pathology.
What I've come to realize is that the body is organized to use the joints of the axial and appendicular skeleton in a very similar fashion to an electrical circuit-breaker system in a more modern home. Organ correlation to segmental levels of the spinal cord are referred to as spinal correspondences and are maps to the work of chiropractors and the osteopaths who directly manipulate the joints.
Regional reflex areas, such as the right shoulder/scapula area associated with liver/gall bladder congestion, stasis and disease, are referenced in some medical textbooks but are more commonly found, and their relevance more usefully described, in surgical references.3
The paradigm of working from the "inside-out" suggests that as massage therapists, we need to learn how to equalize the pressures within the tubes, sacs, and cavities of the body as a first step to assisting our clients. Additionally, knowledge of the aforementioned spinal correspondences and regional reflex areas can be invaluable for making timely and appropriate referral of our clients to medical care from the onset of working with them, or when they are not making progress.
Competent massage therapy of any orientation will assist stress-induced states of congestion to dissipate with a lessening or disappearance of the initial symptoms. When this doesn't occur, it is our ethical responsibility to encourage medical evaluation. A "well-baby" visit to a physician can be invaluable to the mental health of a client who fears something is amiss.
Stress-related problems follow the progression offered in the first article: adaptation, compensation/substitution, injury/illness, degeneration/disease. Trauma simply speeds one along the continuum. It is common for a client to have all the relevant medical tests and return for additional work as what is brewing within them has not reached the tipping point of recognizable pathology.
Now to lightly kiss the question of why stress affects some people more than others and some in particular areas, while others in totally different ways. As humans, we assign meaning to our experiences in life. We develop a complex array of positive and negative anticipations to events. We live in the models of our mind more than in the present time, experience of life unfolding moment by moment. This is the arena of consciousness and is the most powerful tool for change and evolution for ourselves and our species.
My experience professionally and personally reflects an additional existential theorem, as well: Our bodies are our vehicles for the development of consciousness, the growth of our soul and spirit, and the integration of our personality and spirit. Our bodies are where the action is happening. It embodies our confusions and terrors, our willingness and readiness for change. The body really does reflect a Map of Consciousness.4
Touch bridges time and space, and is the vehicle for re-modeling our inner landscape of attitudes, possibilities and behavior.
For those new to the profession, much of this may have been more than a mouthful, or simply tedious reading, yet it is what we are challenged to hold in our work, and there is more. It has taken years of concentrated experience and study across many disciplines to tease apart the foundational elements of anatomy and physiology to make sense of how the gestalt of the body works in relation to its dance with the psyche.
In truth, this paradigm of working from the inside-out is only the springboard for many connections that are to come in future years.
These basics, and others to follow, have consistently shown themselves to be fundamental to working with clients, especially those with chronic problems. Our real challenge is to expand our perception broadly to include additional dimensions and to nurture our quality of touch to assist our clients to integrate themselves across the many levels of human consciousness.
Click here for more information about Dale G. Alexander, LMT, MA, PhD.
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